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JOURNAL OF APPLIED BEHAVIOR ANALYSIS 2003, 36, 259–261 NUMBER 2 (SUMMER 2003)

FUNCTIONAL ANALYSIS AND TREATMENT OFVERBAL PERSEVERATIONS DISPLAYED BY

AN ADULT WITH AUTISM

RUTH ANNE REHFELDT AND MARK R. CHAMBERS

SOUTHERN ILLINOIS UNIVERSITY

The function of perseverative speech for an adult man who had been diagnosed withautism and mental retardation was examined. Results showed that verbal perseverationswere maintained by social attention. An intervention consisting of differential reinforce-ment of appropriate verbal responses and extinction of perseverative verbal respondingwas effective in decreasing verbal perseverations.

DESCRIPTORS: verbal perseverations, functional analysis, autism

Individuals with autism often display ste-reotyped or repetitive use of language, suchas perseverating on the same subject. Behav-ior-analytic efforts have shown that similarimpairments in language and communica-tion exhibited by persons with autism areoften under environmental control, and canbe reduced via the systematic arrangementof environmental variables. For example,Schreibman and Carr (1978) differentiallyreinforced stating ‘‘I don’t know’’ in responseto unfamiliar questions, and as a result,echolalia was reduced in children with au-tism. Similarly, Durand and Crimmins(1987) showed that a child’s inappropriatespeech was maintained by escape from de-mands. Similar results have been obtainedfor the bizarre, delusional vocalizations ex-hibited by individuals with schizophrenia(e.g., DeLeon, Arnold, Rodriguez-Catter, &Uy, 2003; Dixon, Benedict, & Larson,2001; Wilder, Masuda, O’Connor, & Ba-ham, 2001). In the present report, we ex-tended these studies by conducting an anal-

We extend our thanks to Specialized Training andAdult Rehabilitation in Murphysboro, Illinois. Specialthanks to Dana Dahman, Julia Lenhoff, and HeatherSobery for assisting with the reliability data.

Address correspondence to Ruth Anne Rehfeldt,Rehabilitation Institute, Rehabilitation Services pro-gram, Mailcode 4609, Southern Illinois University,Carbondale, Illinois 62901-4609 (e-mail: rehfeldt@siu.edu).

ysis of the verbal perseverations displayed bya man with autism that were maintained bysocial attention.

METHOD

Participant and SettingVince was a 23-year-old man who had

been diagnosed with autism and mild men-tal retardation. He also experienced seizuresthat were controlled by medication. Vincetook 100 mg of Phenytoin four times daily,100 mg of Sertraline once daily, 10 mg ofBisoprolol once daily, and 100 mg of Tra-zedone once daily throughout the durationof the study. Vince attended a shelteredworkshop. When given the opportunity toconverse, he typically perseverated on spe-cific topics. All sessions were conducted in aroom that included a table and chairs.

Response Measurement and InterobserverAgreement

Perseverative speech was defined as dis-crete statements that occurred at least 3 sapart and focused on one the following top-ics: (a) sirens or alarms, (b) dentist or doctorappointments, or (c) coughing. All subse-quent comments emitted during a sessionthat focused on one of these topics werescored as perseverative. Appropriate verbalresponses (defined as statements or questions

260 RUTH ANNE REHFELDT and MARK R. CHAMBERS

that occurred at least 3 s apart and were notfocused on the above three topics) were alsorecorded during the last half of the interven-tion. Frequency counts of appropriate andinappropriate verbal responses were record-ed. Interobserver agreement was collectedduring 30% of the sessions and was calcu-lated for each category by dividing the small-er number of verbal responses by the largernumber of verbal responses and multiplyingby 100%. The mean agreement was 90% forperseverative (range, 83% to 100%) and92% for appropriate (range, 71% to 100%)verbal responses.

Procedure

All sessions lasted 10 min. A multiele-ment design was used for the analogue func-tional analysis, and a reversal (BABAB) de-sign was used to study the intervention ef-fects.

Functional analysis. Four functional anal-ysis conditions were randomly alternated.During the attention condition, 10 s of at-tention was provided contingent upon verbalperseverations. This attention included bothreciprocal statements (e.g., ‘‘you sure do likethose sirens, don’t you?’’) and mild repri-mands (e.g., ‘‘you shouldn’t talk about sirensso much at work’’). Vince typically receivedboth forms of attention from staff contin-gent on inappropriate verbal behavior duringhis work day. During the demand condition,Vince was asked to complete the same vo-cational tasks that he typically completedover the course of his work day (e.g., papersorting and filing). Each instance of verbalperseveration produced 30 s of escape fromthe tasks. During the alone condition, Vinceremained in the room alone, and the exper-imenter recorded his verbal responses fromoutside the room. During the tangible con-dition, Vince was provided with 30 s of ac-cess to preferred activities (writing about si-rens, fire drills, etc.) contingent upon verbalperseverations.

Baseline for intervention. A baseline con-dition, identical to the attention conditionof the functional analysis, was used to eval-uate the frequency of Vince’s perseverativeverbal responses in the absence of interven-tion.

Attention intervention. The interventionconsisted of differential reinforcement of al-ternative (DRA) verbal responses (i.e., ap-propriate and nonperseverative) and extinc-tion of verbal perseverations. Approximately5 s of attention and eye contact were pro-vided contingent on appropriate verbal re-sponses. The experimenter did not respondwith verbal statements or eye contact whenVince emitted inappropriate verbal behavior.

RESULTS AND DISCUSSION

The top panel of Figure 1 shows the num-ber of perseverative verbal responses duringthe functional analysis. These results indicatethat perseverative speech was maintained bysocial attention. The bottom panel showsthe effects of the intervention (DRA and ex-tinction). The data indicate that the inter-vention was successful in reducing Vince’sperseverative speech each time the interven-tion was in effect, relative to the baseline.Also shown is the number of appropriateverbal responses that were recorded duringthe contingency reversals. The data indicatethat the intervention was effective in increas-ing Vince’s appropriate verbal responses.

These results extend earlier findings thatshowed that the unusual speech of peoplewith autism is sensitive to environmentalcontingencies (DeLeon et al., 2003; Durand& Crimmins, 1987; Schreibman & Carr,1978) and underscore the valuable role thatfunctional analysis methodology can play inimproving the conversational skills of peoplewith autism. These results also replicate thefindings of Wilder et al. (2001), in which aDRA and extinction intervention decreasedinappropriate speech and increased appro-

261VERBAL PERSEVERATIONS

Figure 1. The number of perseverative verbal responses emitted by Vince during the four conditions of thefunctional analysis (top panel) and the number of perseverative and appropriate verbal responses during thebaseline and intervention phases (bottom panel).

priate speech. A limitation of this study isthat the generality of these findings to Vin-ce’s everyday work environment was not es-tablished. Future research should address thegeneralization of treatment gains to morenaturalistic settings.

REFERENCESDeLeon, I. G., Arnold, K. L., Rodriguez-Catter, V.,

& Uy, M. L. (2003). Covariation between bizarreand nonbizarre speech as a function of the contentof verbal attention. Journal of Applied BehaviorAnalysis, 36, 101–104.

Dixon, M. R., Benedict, H., & Larson, T. (2001).Functional analysis and treatment of inappropri-

ate verbal behavior. Journal of Applied BehaviorAnalysis, 34, 361–363.

Durand, V. M., & Crimmins, D. B. (1987). Assess-ment and treatment of psychotic speech in an au-tistic child. Journal of Autism and DevelopmentalDisorders, 17, 17–28.

Schreibman, L., & Carr, E. G. (1978). Eliminationof echolalic responding to questions through thetraining of a generalized verbal response. Journalof Applied Behavior Analysis, 11, 453–463.

Wilder, D. A., Masuda, A., O’Connor, C., & Baham,M. (2001). Brief functional analysis and treat-ment of bizarre vocalizations in an adult withschizophrenia. Journal of Applied Behavior Analysis,34, 65–68.

Received June 10, 2002Final acceptance February 18, 2003Action Editor, Craig Kennedy